2 - Department of Psychiatry

InPsych
Summer, 2014
NewYork-Presbyterian’s Psychiatry Programs Jump to #2 in the Nation in the
US News & World Report Ranking
In the annual U.S. News & World Report “Best
Hospitals” rankings, published online July 15,
NewYork-Presbyterian Hospital ranked second in the
nation for psychiatry and number one in New York.
Psychiatry jumped two places this year, with a very
strong score – less than one percentage point behind
the first place program. NewYork-Presbyterian again
earned the top spot among all hospitals in New York
State and the New York metro region, and moved up
to #6 nationally. For the 14th consecutive year, the
hospital was included in the prestigious Honor Roll,
which recognizes national excellence in multiple
specialties.
In This Issue
2..... Message from the Chairman & Director
Jeffrey A. Lieberman, MD & Research News
3..... Awards & Recognitions &
New Grants
4..... Research News &
New Roles
5......2014 Annual Meeting
6-7...Development &
Special Events
8.......Alumni News
9...... Education News
10.....LGBT Health Initiative
11.....Research Studies
12.....Departmental Reading List
InPysch Editorial Office:
Dawn de León, David Hellerstein,
Dacia Morris, Ray Smith,
Eve Vagg, Rachel Yarmolinsky
Questions or comments to
[email protected]
Columbia University
Department of Psychiatry
1New York State
Psychiatric
Institute
1
This recognition of our stellar clinical services, with Dr.
Grant Mitchell at the helm, comes as just as they are
undergoing an expansion to provide greater access to
psychiatric care to more patients (see article below).
The growth and excellence of the clinical programs
rely in no small part on the insights gained from our
research studies, enabling clinicians to deliver the
highest quality patient-centered
and evidence-based care.
“This recognition in the US
News & World Report is
a credit to the talent and
professionalism of our faculty and the staff who
support their efforts on a daily basis,” said Dr.
Jeffrey Lieberman, Psychiatrist-in-Chief at New York
Presbyterian Hospital-Columbia University Medical
Center.* “Every individual in the department of
psychiatry, working collaboratively and efficiently, is
dedicated to helping people with psychiatric disorders
and ensuring that they receive the best possible
care and the support they need to reach their fullest
potential as contributing members of our society.
This acknowledgment - on such a national scale – is a
tribute to the efforts of the entire department.”
The rankings are published at http://health.usnews.com/besthospitals and are available in print in the U.S. News “Best
Hospitals” 2014-15 issue, available in bookstores and on
newsstands August 26.
*See also “Message from the Chairman and Director,” page 2.
Clinical Services Update: Building Towards the Future
A year after his arrival Grant
Mitchell, MD, Vice Chair for
Clinical Services, is seeing
the fruits of his team’s labor.
A number of priorities took
shape following listening
sessions with faculty and
staff to establish where
there may be gaps in patient
care services and to identify
strategies for improvement.
An initial priority was
continuing to integrate the
department’s clinical services
by building a searchable, easilynavigated database that was
inclusive of services across the
medical center campus. Clinicians
and patients will soon have full
access to information about
every psychiatric resource in the
department.
In the meantime, the referral line
at 212-305-6001—which is the
central entry point for individuals
seeking clinical care as well as
research studies — now has a
well-trained team with expertise
in screening as well as access to
the full complement of services in
the department. It is experiencing
record numbers of inquiries from
callers.
Our clinical research units at
the New York State Psychiatric
Institute continue to provide
treatment for patients
who
volunteer
for
research studies to further
understand the causes of
and improve treatments
for psychiatric disorders,
including schizophrenia,
mood disorders, eating
disorders and substance
abuse.
Patients with
serious mental illness
from the community,
many of whom lack
insurance, receive care on the
Washington Heights Community
Service (WHCS), a 21-bed
inpatient unit. The combined
54-bed units at NewYorkPresbyterian’s
Milstein
and
Allen Hospitals are yet another
resource for patients (where
more than 900 received inpatient
treatment last year) in addition
to the consultation-liaison and
(continued on page 8)
Message from Chairman & Director
Jeffrey A. Lieberman, MD
Behind the Rankings:
Providing the Best
Care for Our Patients
For the last ten years the
Psychiatry programs at NewYorkPresbyterian have ranked among the top five in the United
States -- and this year moved from 4th into 2nd place, less
than one percentage point behind Massachusetts General
Hospital at the top of the Honor Roll.
It is both gratifying and humbling to be recognized as
one of the nation’s premiere psychiatry services for so
many years, an achievement which rests squarely on the
extraordinary efforts of our dedicated and caring faculty
and staff to deliver state-of the art care to our patients.
Our competition is not the other excellent hospitals and
medical centers against whom we are measured, rather
we are competing against the devastating diseases of the
brain, working to reduce the suffering that they cause. Our
goal is to find the best ways to achieve our mission - to
reduce the burden of mental illnesses on individuals, their
families and society. Recognition of how well we do our
work is welcome in large part because it helps reduce the
stigma of mental illness, and makes it easier for for people
suffering from mental illnesses to seek help. Identifying
the best care also makes it easier for people to get the right
care. Complex, difficult to manage, treatment-resistant
illnesses are something we see and care for every day at
NYSPI/Columbia Psychiatry: we are indeed the place to go
for successful treatment.
My congratulations and appreciation go to our residents,
faculty, and staff in our emergency room and hospital
services, our research clinics and units, our specialty
services, and all our inpatient and outpatient facilities for
caring for patients with warmth and expertise, for their
success in combining innovation and experience, making
this honor a reality.
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ResearchNews
DNA on the Witness Stand: Courts Face Challenges
When Linking Genetics to Criminal Behavior
Studies suggest that some people
may be at increased risk of criminal
behavior because of their genes. Such
research has the potential to help
judges and juries with some of the
difficult decisions they must make,
but it also brings a substantial risk of
misinterpretation and misuse within
the legal system. Addressing these
issues will be of critical importance
in upholding principles of justice
and fairness, according to a paper
published in the June 4 issue of the
Cell Press journal Neuron.
“Genetic evidence, properly used,
could assist with judgments regarding
appropriate criminal punishments,
causes of injury or disability, and
other questions before the courts,”
said author Paul Appelbaum, MD,
director of Columbia University’s
Center for Research on Ethical, Legal
& Social Implications of Psychiatric,
Neurologic & Behavioral Genetics and
the Elizabeth K. Dollard Professor in
Columbia’s Department of Psychiatry.
Genetic evidence has been presented
in criminal trials to suggest that
defendants
have
diminished
understanding of or control over their
behavior, most often in arguments for
mitigating sentences—especially for
defendants facing the death penalty.
Genetic evidence may also play an
increasing role in civil trials regarding
issues such as causation of injury. For
example, employers contesting workrelated mental disability claims might
want claimants to undergo genetic
testing to prove that an underlying
disorder was not responsible for their
impairment.
“The complexity of genetic information
and our incomplete understanding
of the roots of behavior raise the
possibility that genetic evidence
will be misused or misunderstood.
Hence, care is needed in evaluating
the extent to which genetic evidence
may have something to add to the
legal proceedings in a given case,”
said Dr. Appelbaum, who is also
Director of the Division of Law, Ethics
and Psychiatry at the New York State
Psychiatric Institute.
A number of questions must be
addressed. For example, to what
extent do specific genetic variants
make it more difficult to understand
or control one’s behavior, and what
are the biological mechanisms
involved? Also, what is the best way
to respond to individuals with genetic
predispositions to criminal behavior,
to diminish the risk of recidivism?
Dr. Appelbaum notes that it will be
an ongoing challenge for both legal
and genetic experts to monitor the
use of genetic data in the courts to
ensure that the conclusions drawn
validly reflect current science. Without
such efforts, judges and juries may
overestimate or underestimate the
conclusions that can be drawn from
genetic evidence, distorting the legal
process.
Work on this paper was supported
by a grant from the National
Human Genome Research Institute
(1P50HG007257-02)
*This release was originally prepared and
distributed by Cell Press.
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Awards&Recognitions
Deborah L. Cabaniss, MD,
Director of Psychotherapy
Training in the Columbia
University Department of
Psychiatry, and Director of
the Virginia Apgar Academy
of Medical Educators,
received a Presidential
Award for Outstanding Teaching from President
Lee Bollinger at this year’s Columbia University
Commencement on May 21st. The Presidential
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Award for Outstanding Teaching is the highest
award for teaching offered at the University,
and this year five professors were chosen from
over 500 nominations. President Bollinger’s
commendation of Dr. Cabaniss noted that she
has “revolutionized the way psychotherapy is
taught in the residency, in the medical school,
and through her books and workshops, around
the entire country. She has “begun to integrate
cognitive neuroscience into the understanding of
Robert Klitzman, MD, Director of the Masters of Bioethics
Program, was one of nine leaders in bioethics named a
Hastings Center fellow. Fellows are an elected association
of researchers from around the world whose distinguished
contributions in their fields have been influential in bioethics.
Stephanie LeMelle, MD, the Co-Director of Public Psychiatry
Education was named to the Task Force on Behavioral Health
and the Criminal Justice System. The announcement was
issued by Mayor DeBlasio’s office on June 2, 2014.
“The task force will create opportunities to reduce crime and costs by
treating the mental ill outside of the criminal justice system; identify effective
approaches to medical and mental health care while incarcerated; develop
better standards for transition from jail back into the community; and
establish targeted treatment upon release. As part of these efforts, the task
force will develop strategies for the city’s jails to improve the provision of
mental health services for mentally ill inmates already in the criminal justice
system, which place particular strain on the system.”
psychodynamic mechanisms,” and that, “before
the term ‘flipped classroom’ became fashionable”
she flipped it, challenging her students to
participate actively in every class.”
Valued by the entire CUMC community for her
excellence as an educator, Dr. Cabaniss was
made the Director of the Virginia Apgar Academy
of Medical Educators in 2011, and she has
been a campus-wide leader in shaping the new
educational track system.
Carolyn Rodriguez, MD, PhD, was awarded the Harold
Amos Medical Faculty Development Award. Formerly the
Minority Medical Faculty Development Program, the award
will help her to complete her project, “Neural Mechanisms
Underlying Fast-Onset OCD Treatment across Molecules,
Physiology and Circuits.” Dr. Rodriguez was one of 10
finalists selected out of 74 applicants. This award provides part salary
support ($75K) and research support ($30K) for the next 4 years. “One of
the most exciting parts of the program is being a part of the Harold Amos
community, which is comprised of diverse leaders within academia, NIH, and
pharmaceutical industry. They are all on a mission to increase the number of
faculty from historically disadvantaged backgrounds who can achieve senior
rank (professor) in academic medicine and who can serve as role models for
students and faculty of similar background.” http://www.amfdp.org/about
Martha Welch, MD, a graduate of the class of 1971 at the
Columbia University College of Physicians & Surgeons was
named a 2014 Alumni Gold Medalist in recognition of her
“service to the alumni association and for excellence in clinical
and medical research.”
NewGrants
Neil Krishan Aggarwal, MD (Clinical Therapeutics)
was awarded a grant from the National Institute of
Mental Health in the amount of $730,701.The title
of his study is “The Cultural Formulation InterviewEngagement Aid for Mental Health Treatment.”
Alex Carballo-Diéguez, PhD (Gender, Sexuality, and
Health) received a National Institute of Child Health
and Human Development grant in the amount of
$3,100,482 for a study on “Use of Rapid HIV SelfTest by High Risk Populations.”
Davangere Devanand, MD, MBBS (Geriatric
Psychiatry), received an R01 from the National
Institute on Aging to support his study, “Treatment
of Psychosis and Agitation in Alzheimer’s Disease.”
The five-year grant totals $2,893,758.
Zoe Donaldson, PhD (Integrative Neuroscience)
received a National Institute of Mental Health grant
in the amount of $263,512 for two years. The title
of her study is “Variation in Serotonin 1a Receptor
Expression as a Source of Depression Risk.”
33
Richard Foltin, PhD (Substance Abuse) and Yuanjia
Wang, PhD (Biostatistics) received a new R01 from
the National Institute on Drug Abuse in the amount
of $2,975,374. The study, “Impulsivity in Cocaine
Abusers: Relationship to Drug Taking and Treatment
Outcome,” is funded for five years.
Guillermo Horga, MD (Translational Imaging)
received a grant from the National Institute of Mental
Health in the amount of $919,398 for a period of
five years. His study is titled “Neural Mechanisms
of Sensory Predictions in Schizophrenia with
Hallucinations.”
Joanne Mantell, MS, MSPH, PhD (Gender, Sexuality,
and Health) received a USAID grant in the amount of
$1,733,190 to support her study, “Evaluation of the
National South African Female Condom Program:
Investigating Factors Associated With Uptake and
Sustained Use.”
Child & Adolescent Psychiatry researchers Rachel
Marsh, PhD, and Moira Rynn, MD, received a grant
from the National Institute of Mental Health in the
amount of $454,663. The study, “The Functioning of
Overlapping Frontostriatal Circuits in Children with
OCD” is funded for two years.
Eleanor Murphy, PhD, (Epidemiology) received an
award from the National Institute on Minority Health
and Health Disparities in the amount of $719,298
over a three-year period. The title of her study is
“Influences on the Familiality of Major Depression
among African-Americans.”
Nasir Naqvi, MD (Substance Abuse) received an
award from the National Institute on Alcohol Abuse
and Alcoholism in the amount of $930,960 over
a five-year period to fund: “The Role of Neural
Systems for Emotion Regulation in Coping with
Alcohol Craving.”
Milton Wainberg, MD (Gender, Sexuality and Health)
and Maria Oquendo, MD (Residency Training)
received a grant from Fogarty International Center
in the amount of $1,172,791 for a period of five
years for “The PALOP Mental Health Implementation
Research Training.”
www.columbiapsychiatry.org
ResearchNews
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Study of Long-Acting Injectable Antipsychotics Finds Older Treatment an Effective, Less-Expensive
Option for Patients with History of Non-Adherence
A study of long-acting injectable antipsychotics
for people with schizophrenia found that
the newer, second-generation, medication
paliperidone palmitate was no more effective
than the older, less expensive haloperidol
decanoate. This was so, even though the doses
of the older medication given in the study were
considerably lower than standard doses of the
past. The study was published in the May 21st
issue of JAMA.
Scott Stroup, MD, MPH, and colleagues
affiliated with the National Institute of Mental
Health-supported Schizophrenia Trials Network
compared the two medications in 311 patients
diagnosed with schizophrenia or schizoaffective
disorder. “The two drugs were very similar to
each other, and both were better than expected
at preventing relapse,” said Dr. Stroup, a
professor of psychiatry at Columbia University
and the New York State Psychiatric Institute.
Treatment adherence is a challenge for many
patients with schizophrenia, especially with
oral medications that must be taken daily. Many
experts believe that the use of long-acting
injectable antipsychotics to improve adherence
is underused.
“The use of long-acting injectable medications
is an important strategy that may lead to
fewer relapses and better outcomes,” said Dr.
Stroup. “We should think of using long-acting
injectables when there is a risk of relapse due
to medication non-adherence. But it’s not
necessary to start with an expensive, new longacting medication.”
“This study,” he said, “also demonstrates the
importance of independently funded research
(continued on page 8)
NewRoles
Andrew Gerber, MD, PhD
Dr. Andrew Gerber was appointed Director of the
NYSPI MRI Research Program. Dr. Gerber served
as interim director during a period of transition in
the MRI operation and distinguished himself
as a leader, collaborator and agent of change.
With direction and support provided by the MRI
Operations Committee (Alayar Kangarlu, Larry Kegeles, Rachel Marsh,
Ravi Bansal, and Janelle Greenhill), input from Institute investigators,
research staff and colleagues around the Medical School and University,
he has made great progress in re-shaping this core research service to
reflect its core mission and values—quality science, access, transparency
and efficiency.
Dr. Gerber received a BS in physics from Yale University, a MSc. and PhD
in Developmental Psychology from University College, London, and an
MD from Harvard. He completed his adult psychiatry training at NYPCornell and earned a degree in Psychoanalysis from the Columbia Center
for Psychoanalytic Training and Research. He went on to an NIMH postdoctoral Research Fellowship at Columbia followed by training in Child
and Adolescent Psychiatry in our joint NYPH Columbia-Cornell child and
adolescent psychiatric residency program. Dr. Gerber subsequently
served as medical director and co-director of our Developmental
Neuropsychiatry Program, Co-director of the Division of Parent-Infant
Psychotherapy of the Sackler Institute, and Director of Research of the
Columbia Psychoanalytic Center. He currently holds the rank of assistant
professor of psychiatry at CUMC.
His funded research activities have centered on neurodevelopmental
disorders and the use of magnetic resonance imaging (fMRI) to study
psychopathology and change in response to psychotherapy, with
additional focus on social cognition and autism spectrum disorders. He
has published papers and book chapters on randomized controlled trials
of psychotherapy, fMRI studies of affect, and the use of fMRI to study
psychotherapeutic change. His particular MRI expertise involves the use
4
of a range of software tools for fMRI image processing and analysis. He
has received awards and recognitions too numerous to mention. He
is a highly regarded teacher and mentor and is a tireless and selfless
contributor to department activities, committees and functions.
Corinne Rogers, MS, CIP
Corinne Rogers was appointed the Institutional
Review Board (IRB) Director of Operations for
NYSPI in June 2014. Ms. Rogers has served as
a Protocol Manager with the IRB for nearly 12
years, working closely with IRB Chairs and the IRB
Administrative Director. Exceedingly knowledgeable
about the federal regulations governing human subjects research, she is
a strong advocate for study participants and very supportive of clinical
investigators and their research.
In her new role, Ms. Rogers will oversee all operations related to the
function and provision of services from the IRB Office. She will work with
the Executive Director and IRB Chairs to identify office processes that
encumber expeditious protocol review. Under her skillful stewardship,
IRB office operations will be streamlined, and made more transparent and
effective. Corinne is also expert in the use of Protocol Review Information
and System Management (PRISM). She has been instrumental in
training investigators on the use of PRISM through a series of hands-on
workshops, and will continue to provide this instruction along with our
informatics team.
Prior to arriving to NYSPI in 2002, Corinne was the Assistant Director
of Addiction Medicine Research at Montefiore Medical Center and on
faculty with the Department of Psychiatry, Albert Einstein College of
Medicine. Corinne holds a Master’s of Science Degree in Psychology
from the College of Mount Saint Vincent in New York, and is a Certified
IRB Professional. She is also an active member of Public Responsibility
in Medicine and Research, a prominent national organization dedicated
to human research protection training and education.
www.columbiapsychiatry.org
2014AnnualMeeting
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At the Annual Meeting on June 13, Chair and Director Jeffrey Lieberman, MD, along with Vice Chairs Maria Oquendo (Education), Grant
Mitchell (Clinical Services), David Strauss (Research Administration, Ethics and Policy), Avalon Lance (Administration and Finance),
and Anke Ehrhardt (Academic Affairs), reviewed the achievements of the past year and the prospects for the coming year at Columbia
Psychiatry/NYSPI. The presentations demonstrated the strength of our combined resources across the institute, the department and the
hospital, our focus on strategic planning and development, and the breadth of our research, education and clinical programs underlying
the extraordinary work of our dedicated and talented faculty and staff.
Please click here for a pdf of the 2013-2014 Highlights.
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Development&SpecialEvents
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Hopeful Dawn Foundation’s 4 Million Dollar Commitment to Support PostTraumatic Stress Disorder (PTSD) Research at Columbia Psychiatry
Earlier this summer, with an extraordinarily
generous $4 million commitment, the
Hopeful Dawn Foundation established the
PTSD and Trauma Research and Treatment
Program at Columbia Psychiatry. The
program, under the direction of Dr. Yuval Neria, Professor of Medical Psychology, will focus on collaborative efforts across Columbia
University Medical Center aiming to develop applied knowledge about mechanisms and neural targets of post-trauma psychopathology
that will aid in objective assessment of psychopathology, and facilitate development of neuroscience-informed, well-targeted, effective
treatments.
In addition, the Foundation’s sponsorship of an international program focused on PTSD allows for a unique collaboration between
Columbia University Medical Center and Tel Aviv University. Based in New York at the Department of Psychiatry’s PTSD and Trauma
Research and Treatment Program, and in Israel at the PTSD Center at the School of Psychological Sciences, this international,
interdisciplinary venture will create state-of-the-art programs for research, education, prevention and treatment of PTSD.
Understanding PTSD, its origins and expressions, and how best to treat those diagnosed with it, are pressing priorities for Columbia’s
Department of Psychiatry. This program will bring together psychologists, epidemiologists, neuroscientists, and psychiatrists in our
efforts to help those who contend with PTSD – in the United States alone, 5.2 million veterans and civilians are effected by posttraumatic stress disorder. As Dr. Jeffrey A. Lieberman, Chairman of the Department of Psychiatry at Columbia, noted: “The effects of
emotional trauma on mental function, particularly in the context of military combat, has been understudied for too long and is a critical
public health priority. We are grateful for this generous support to Columbia and Tel Aviv Universities to expand our research and
services in PTSD.”
Dr. Yuval Neria, Director of the Columbia PTSD program, will collaborate closely with his counterpart at Tel Aviv University, Dr. Yair BarHaim, with the goal of advancing translational science of trauma and its psychopathology. They will be working not only with colleagues
at their institutions, but also with representatives of the military and political communities, ensuring that their research is informed by
the most recent real-world developments, and that their results can have the greatest possible impact.
Established in 2013, the Hopeful Dawn Foundation is dedicated to the research, prevention and treatment of war veterans and other
young adults who suffer from trauma, PTSD and other related psychiatric disorders.
The Chairman’s Frontier Fund is the annual fund of Columbia Psychiatry, and
provides critical support for our core mission. The name is inspired by the brain itself
– one of the last true frontiers of exploration and discovery, and the focus of our vital
research at Columbia Psychiatry. The Chairman’s Frontier Fund helps support new
initiatives, as well as ongoing projects that have a direct impact on the quality of the
education, research, and services Columbia Psychiatry can provide.
Columbia Psychiatry is proud to be an international leader in the field of psychiatric medicine, and gifts to the Chairman’s Frontier Fund make
a significant difference in our work. We are extremely grateful to our dedicated supporters for their generosity.
To learn more about the Chairman’s Frontier Fund or to make a gift, please contact Dawn de León, Senior Director of Development,
at (212) 304-6670 or [email protected].
Thank you for your support of Columbia Psychiatry!
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Development&SpecialEvents
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Gray Matters at Columbia
On Monday, May 12, National Book Award winning author Andrew Solomon and
Oscar nominated actress Glenn Close joined Dr. Jeffrey A. Lieberman at the Plaza
Hotel for the Gray Matters at Columbia Annual Spring Benefit Luncheon honoring
noted fashion designer and philanthropist Dana Buchman. The more than 400 guests surpassed last year’s
fundraising goal, raising $538,000.
Spring Benefit Luncheon
Gray Matters at Columbia is a research fund within Columbia University Medical Center’s Department of
Psychiatry that provides support for outstanding scientists dedicated to searching for the causes and cures of
brain disorders. The Spring Benefit Luncheon is the major annual fundraising event by Columbia Psychiatry to
support research on brain disorders through the Chairman’s initiatives for the department. Since its inception
in 2007, it has raised funds to support chosen fellows who benefit from the extensive expertise of a peerless
team of talented scientists – including a Nobel laureate – who serve as their teachers and mentors. It is
organized and run by a dedicated volunteer committee and is a beacon of hope to all who struggle with brain
disorders.
“Research continues to be critical in advancing the development of life-saving treatments for psychiatric
disorders,” said Dr. Lieberman. “Support from families and committed citizens is more important than ever
given the economic pressures and reductions in funding that researchers face.”
Andrew Solomon, Glenn Close, Jeffrey Lieberman, Dana Buchman,
Rosemarie Lieberman, Jill Goldman, Lee Goldman
Ms. Close has spoken openly about her family’s experience with mental illness and that insight was the catalyst for Bring Change 2 Mind, which aims to end stigma and
discrimination surrounding mental illness. It was difficulty accessing resources for her child that led Ms. Buchman to found the Promise Project, which helps underserved
children with learning disabilities get the services they need. Also honored was Giuseppe Bruno, owner of the celebrated Italian restaurant Sistina. Mr. Bruno, who was
given a special Advocacy Award, has hosted events to support brain trauma and post traumatic stress disorder research at Columbia Psychiatry.
Jeanine Ramonas, Patricia Ramonas,
Jennifer Weis Monsky
Brigitt Rok, Lyn Paulsin
Charlotte Farber, Dana Buchman
Giuseppe Bruno,
Marianne Mebane
Patsy Kahn, Lori Rosenfeld, Diane Finnerty
Patricia Rosenwald, Frederic Adler
Kitty de Chazal, Elena Patterson,
Elizabeth Hoguet
Monica Sagner, Karen Hsu,
Maria Esperanza Hernandez
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Jeffrey Lieberman, Betina Farkas,
Leonardo Farkas
Lisa Gentil, Teresa Melhado
The 2013-14 Gray Matters Fellows are Holly Moore, PhD
(Schizophrenia); Sidney Hankerson, MD (Depression); Rachel Marsh,
PhD (Pediatric Neuroimaging); and Amir Levine, MD (Addiction,
Adolescent Brain Development)
Glenn Close
Lila Alizadeh, Sarah Long Solomon, Audrey
Dinkeloo, Nina Matza, Nancy Feinglass
Michael Tusiani, Giuseppe Bruno
Claudia McNulty-Jensen, Joe Jensen,
Jennifer Buckner
Vanessa Timken-Stelling , Rosemarie Lieberman,
Petra Stelling, Annette Swanstrom
Ginny Millhiser, Charlotte Ford,
Jeffrey Lieberman, Monica Sagner, Anne Ford
Jeffrey Lieberman, Karen Kolster, Dana Buchman,
Donna Hanover, Glenn Close, Giuseppe Bruno
www.columbiapsychiatry.org
AlumniNews
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Are you a Columbia Department of Psychiatry alumni? We’d like to hear from you! Let us know how you’re doing so we can share the
news with your fellow classmates. Please send your news (including year of graduation) to [email protected].
1990s
Avrim Fishkind, MD, (Class of 1995) developed the Mental Health
Emergency Center (MHEC) model as a consultant for the Burke Center
of Lufkin, Texas. The MHEC model won the American Psychiatric
Association Gold Award in 2011 and the National Council for Behavioral
HealthCare Innovations Award in 2013. Most recently, the Burke Center
and JSA Health Telepsychiatry, of which Dr. Fishkind is CEO, were
awarded the 2014 Innovation in Remote Health Care Award by the
American Telemedicine Association.
1960s
In 2013, W. Douglas Skelton, MD, (class of 1967) received the Georgia
Psychiatric Physicians Association Distinguished Service Award for
decades of work to improve mental health services in Georgia. In 2014,
the Mercer University Board of Trustees honored him and his wife with the
naming of its medical library. “I am near the last chapter of a wonderful
career greatly influenced by training at Columbia from ‘64 to ‘67.”
Myra Schatzberg Hatterer, MD, (Class of 1963) is now in part-time
private practice on the Upper East Side. Her free time consists of travelling
and spending time with her family, including her eldest granddaughter,
who just graduated with honors from the Boston University School of
Communication.
Robert E. Feinstein, MD, (Class of 1990) is Professor of Psychiatry at
the University of Colorado, School of Medicine. Formerly, he served
as Senior Associate Dean for Education (2007-2011). His most recent
publications have focused on psychotherapy training as well as violence
prevention in outpatient settings. For the past four years he has been
named the President’s Teaching Scholar, the University of Colorado’s
highest educational award.
1950s
Laurence T. Beahan, MD, (Class of 1959)
completed a book of adventure outings called
Beyond the Adirondacks. Take a look here: http://
amzn.to/1A1QT3I
1970s
Chuck Blackinton, MD, (Class of 1976) is a general psychiatrist with
a subspecialty in geriatric psychiatry. He writes that he has moved his
practice back to Bergen County, NJ from Cape May County to be closer to
his children. He attended this year’s APA, which he “thoroughly enjoyed.”
Clinical Services Update: Building Towards the Future
ambulatory services for adults and children. An
expansion of the emergency department has
helped meet the demand for psychiatric services
for children in crisis. “As hospitals focus on
reducing length of stay and unnecessary readmissions, integrated consultation-liaison
services have become increasingly important,”
said Dr. Mitchell. In the last year, there were
nearly 13,000 such visits.
The WHCS, a multidisciplinary service with
outpatient clinics in Washington Heights an
d Inwood, is the home-base for the OnTrack
NY Clinic. OnTrack provides individualized,
recovery-oriented early intervention care for
patients experiencing their first episode of
schizophrenia. The program is now in its second
year. Patients who get their care at WHCS
will soon have improved access to general
(continued from cover)
healthcare when a primary care physician joins
the mental health team this Fall. “A significant
portion of individuals with serious mental
illness have medical problems and they are less
likely to get those medical issues addressed, in
part because of their illness and in part because
of our fragmented healthcare system,” said
Dr. Mitchell. He added, “We’re going to focus
on prevention, not just treatment, but helping
people with diet, exercise, smoking cessation –
preventative activities that can actually improve
their health.”
The Day Treatment Program, Columbia
Psychiatry’s longstanding outpatient program
providing innovative and integrated treatment
for adults, college students and adolescents
continues to grow since its move last year
to ColumbiaDoctor’s new midtown location
at 51 West 51st Street. In addition to the
Day Treatment programs and the Columbia
University Center for Anxiety and Related
Disorders (CUCARD) programs, Dr. Mitchell is
expanding the clinical services in midtown to
include new programs for both children and
adults.
We will see a further expansion of our
clinical services over the next 36 months as
the department begins to roll out Columbia
Psychiatry outpatient services in Fort Lee, NJ,
Westchester County, and Midtown Manhattan.
Services in these sites will complement the
growth in ColumbiaDoctors services. The first
site should open in midtown in 2015. Said Dr.
Mitchell, “the integration of mind and body,
of psychiatry and other medical specialties –
that’s really the future and we want to be there.”
Study of Long-Acting Injectable Antipsychotics Finds Older Treatment an Effective, Less-Expensive Option for
Patients with History of Non-Adherence (continued from page 4)
8
to provide unbiased comparisons of new and established medications.
Comparative effectiveness research studies such as this one help
determine the appropriate role for new treatments.”
while those assigned the older antipsychotic had more neurologic side
effects, particularly restlessness. All patients, therefore, should be
carefully monitored throughout treatment, said Dr. Stroup.
Though few study participants in either group stopped treatment because
of side effects, the drugs tended to have different side effects. Patients
who were assigned the newer antipsychotic reported more weight gain,
The study was funded by National Institute of Mental Health grants
R01MH081107 and R01MH081234.
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Congratulations to our 2014 Adult Residency Program Graduates!
Marra G. Ackerman, MD
Rachel A. Caravella, MD
Gary Sean Escola, MD, PhD
Dr. Ackerman, who grew up in Vero Beach,
Florida, is a fellow in Consult-Liaison
Psychiatry at Columbia and is researching the
psychological impact of genetic testing for
breast cancer. She earned her BS from Emory
University then pursued her MD at NYU School
of Medicine where she conducted a project in
Cochin, India evaluating barriers to care among
women with advanced breast cancer. During
her residency at Columbia, she developed her
interests in teaching, including co-leading a
new PGY3 psychopharmacology curriculum
and two workshops on physician mental health,
which she presented at APA meetings. She was
honored with the Gold Humanism Award, the
AADPRT Ginsberg Fellowship, and the Barbara
Liskin Award.
Dr. Caravella has elected to remain at Columbia
for a fellowship in Psychosomatic Medicine.
Born and raised in Huntington, NY, she dreamed
of being a detective like Carmen Sandiego.
Instead, she attended the University of
Pennsylvania where she graduated magna cum
laude, earning a BA in both psychology and the
biological basis of behavior. After college, she
moved to Washington, D.C. for an intramural
training award to research the neural substrates
of social cognition in autism at the National
Institute of Mental Health. Realizing she was
more curious about the minds and lives of her
research participants rather than their neural
networks, she set her sights on psychiatry and
earned her MD at Georgetown University School
of Medicine. Dr. Caravella plans to pursue
a career in academic Consultation - Liaison
psychiatry.
Dr. Escola was raised in California, Japan, and
Connecticut before settling in New York City. He
completed undergrad at Columbia, graduating
with a BA in Biochemistry, and never left. He
received his MS in Computer Science and an
MD/PhD all at Columbia, where he continues
his research in the laboratory of Dr. Lawrence
Abbott, developing models to study how neural
circuits in the brain can generate sequences of
behaviors. This line of research may provide
insights into the mechanisms by which normal
sequencing fails in, for example, Parkinson’s
disease and obsessive–compulsive disorder.
Ultimately, Dr. Escola’s goal is to start his own
theoretical neuroscience lab.
Mohsin S. Ahmed, MD, PhD
Enrico G. Castillo, MD
Dr. Ahmed is a native of Rochester, NY where
he grew up in a family of scientists. He is
pursuing a Schizophrenia Research Fellowship
at Columbia. At Cornell University he majored
in neurobiology and chemistry. He spent a year
studying neuroscience at Cambridge University,
and graduated Phi Beta Kappa, Magna Cum
Laude, and with “Academic Distinction in All
Subjects.” Dr. Ahmed then matriculated to the
MD/PhD program at Columbia University and
graduated Alpha Omega Alpha and was awarded
his PhD in Neurobiology and Behavior with
Distinction. As a psychiatry resident, he was
awarded a Leon Levy Neuroscience Fellowship
and received the NIMH Outstanding Resident
Award as well as the American Psychiatric
Foundation/Genentech Schizophrenia Research
Fellowship Award.
Dr. Castillo is a public psychiatry fellow here at
Columbia with a clinical placement at Janian
Medical Care (formerly Project for Psychiatric
Outreach for the Homeless). Born and raised
in Richlands, Virginia, he received his BA with
High Distinction in English at the University
of Virginia and his MD with a Concentration
in Underserved Populations at the University
of Pittsburgh. He is passionate about public
psychiatry, mental health services research, and
cultural psychiatry. During residency, he was
an American Psychiatric Association/SAMHSA
Minority Fellow, for which he created an online
series of filmed interviews focused on Asian
American mental health (www.youtube.com/
user/AsianAmericanMH. His career goals
include clinical care and research focused
on developing, evaluating, and working in
collaborative outreach-based care for the most
severely ill.
Yael Holoshitz, MD
Dr. Holoshitz grew up in Ann Arbor, Michigan,
but is a New Yorker at heart, and moved here
in 2005 to attend medical school at Mount
Sinai School of Medicine. During her time at
Columbia, she developed her interests in clinical
psychiatry, both in acute psychiatric settings and
in psychotherapy. She is thrilled to be staying at
Columbia as a Public Psychiatry Fellow, and to
be working at the Connections to Care/OnTrack
clinic at NYSPI.
Elizabeth A. Horstmann, MD
Dr. Horstmann moved to UCLA where she is
now a child and adolescent psychiatry fellow.
She graduated from Columbia with a BA in
psychology and an interest in illness narratives,
but no idea that she would one day go to medical
school. During a fellowship in the Department of
Clinical Bioethics at the NIH after college, she
started to wonder about a career in medicine.
This led to a post-bac program at Bryn Mawr
College and then a gap year job at the AIDS
Institute of the New York State Department of
Health followed by medical school at Harvard.
(continued on page 10)
99
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Congratulations to our 2014 Adult Residency Program Graduates!
(continued from page 9)
During residency, she received a fellowship from
the APA, which allowed her to do clinical work
in a mental health clinic for the deaf and hard of
hearing and a clinic for children with HIV.
Ryan E. Lawrence, MD
Dr. Lawrence remains at Columbia where he has
joined the clinical faculty on 9 Garden North. He
earned his undergraduate degree in chemistry at
Gordon College in Wenham, MA, and a Master of
Divinity at Gordon-Conwell Theological Seminary
in South Hamilton, MA. He then moved to Chicago
for medical school at the University of Chicago.
While at Columbia he was involved with several
research and writing projects with a number
of prominent faculty, including Drs. Jeffrey
Lieberman, Maria Oquendo, Barbara Stanley, Lisa
Dixon and Paul Appelbaum. He was a fellow with
the American Psychoanalytic Association (20122013), and an OMH Policy Scholar (2013-2014).
Sean X. Luo, MD, PhD
Dr. Luo was born in Shanghai, China, and arrived
in West Lafayette, Indiana on Christmas Eve of
1995. He attended University of Chicago and
received a degree in physics. He then enrolled
in the Medical Scientist Training Program at
Columbia and graduated with an MD/PhD in
2010 in computational neuroscience and machine
learning. He is also actively engaged in the New
York City technology and start-up community to
accelerate implementation of research results
to the bedside. After graduation, he joined
the Substance Abuse Division at Columbia as
a Clinical and Research Fellow and started a
private practice focusing on psychiatric care and
technical consultations, especially relating to
personalized medicine products and treatment of
substance and behavioral addictions.
Mayumi Okuda-Benavides, MD
Dr. Okuda-Benavides is originally from Colombia.
Early on at the Pontificia Universidad Javeriana
in Bogota, she knew she wanted a career in
psychiatry with a strong academic background.
She moved to New York in 2007 and worked at
the New York State Psychiatric Institute where
she had the opportunity to coordinate personnel
and oversee the overall functioning of three
NIH-funded projects. After joining Columbia for
residency training, her research focused on the
epidemiology of addictions and violence, having
published more than 15 peer-reviewed articles on
this area. During the last year of residency, she
got involved in a partnership between Columbia
University’s Department of Psychiatry and
the Bronx Family Justice Center with the dual
purposes of serving the mental health needs
of victims of domestic violence and, through
research, contributing to scientific knowledge that
will allow for improved prevention of intimate and
familial violence.
Larry U. Ozowara, MD
Dr. Ozowara was born in Louisiana and grew
up in Southern California. He attended Stanford
University, where he earned a BA and MA in
psychology, did research in neuro-economics,
and participated on the Division I varsity wrestling
team. Dr. Ozowara attended Stanford University
for medical school, pursuing a scholarly
concentration in biomedical ethics, before coming
to Columbia University for residency. He joined
NYU Langone’s clinical faculty as an attending
psychiatrist at Tisch Hospital. He has also started
a private practice.
Sarah L. Richards Kim, MD
Dr. Richards Kim, a native of Maine, is continuing
her training in child and adolescent psychiatry at
New York Presbyterian Hospital, in the public child
psychiatry track. She is also continuing research
in prenatal interventions with Dr. Catherine Monk
and has started a private practice. She intends
to pursue a clinical career in Women’s Mental
Health, with a focus on early attachment.
While attending Colby College, she first became
interested in children’s mental health. Her first
“real job” teaching at a residential school for
children with autism in Massachusetts inspired
her to pursue a career in child psychiatry.
While at Columbia College of Physicians and
Surgeons, Dr. Richards Kim was introduced
to perinatal psychiatry and published a review
article on treatment of postpartum depression
with the Columbia Women’s Program. During
her residency, she received the APA Child and
Adolescent Fellowship and co-authored a paper
on the positive effects on children of treating
mental illness in parents.
“A Vision for LGBT Health” Event Highlights LGBT Health Initiative
In an significant affirmation of the importance
of the health of lesbian, gay, bisexual, and
transgender (LGBT) people at CUMC and
beyond, the Office of the Dean of the College
of Physicians and Surgeons (P&S) at Columbia
University sponsored a major presentation
and panel discussion on “A Vision for LGBT
Health.” The event was held April 3, 2014 and
opened with remarks by P&S Dean Dr. Lee
Goldman and Vice Dean for Academic Affairs
Dr. Anne Taylor.
“We are at a unique
moment in history with
regard to LGBT rights and
health,” stated keynote
speaker
Dr.
Walter
Bockting, Co-Director of
the LGBT Health Initiative
at CUMC, noting rapid advances in social
attitudes, positive legal decisions concerning
same-sex marriage equality, and constructive
actions taken by government agencies,
academic institutions, and health-care
providers. “At the same time, serious health
disparities and inequities persist in terms of the
quality of and access to the health care system
for LGBT people. “
Dr. Bockting laid out the steps taken by the
LGBT Health Initiative since its founding in 2012
within the Division of Gender, Sexuality, and
Health at Columbia Psychiatry, in association
with the Columbia University School of Nursing.
Among these has been a systematic needs
assessment among providers in Psychiatry
and elsewhere at CUMC, development of LGBTfocused educational programs for residents
and students, the funding of new research
studies on LGBT families and on transgender
identity development, and the expansion of
clinical care for patients who are LGBT.
Echoing
these
sentiments was Dr.
Anke A. Ehrhardt, the
Initiative’s
Director
and the Director of the
Division of Gender,
Sexuality, and Health.
In her role as chair of the panel, Dr. Ehrhardt
noted the sharp contrast between the launch
of the LGBT Health Initiative and that of the
HIV Center for Clinical and Behavioral Studies,
which she founded in 1987 and continues
at NYSPI to the current day. “I’ve been
overwhelmed by the positive reception we
(continued on page 12)
10
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Participating in a Research Study - The View from Both Sides
Participants in research studies help others by contributing to medical research. They can play an active role in their own health care, gain access to
new research treatments and, at Columbia Psychiatry and New York State Psychiatric Institute, receive the highest quality care provided at no-cost.
Call 212-305-6001 to find out more about research and see if participating in a research study is the right choice for you.
In the story below, we hear from a research participant and from one of the doctors in a research study that is investigating a new treatment for
bipolar disorder using ketamine.
A Participant’s Perspective
Carrie (not her real name) is a bright and
articulate 33 year-old upstate New Yorker who
knows a good slice of pizza when she tastes it.
She looks younger than her age, despite having
abused alcohol and various drugs for many
years. In fact, she looks fresh-faced and healthy.
Most people would probably be surprised to
learn that Carrie has bipolar disorder, which
was diagnosed when she was 22 years old
“after a retrospective look at my behaviors and
moods over the years,” she said. Leading up
to that, she’d experienced anxiety beginning at
age 9. Then, at age 12 came the first bouts of
depression that brought with it an “obsession
with suicides and death.” At that point in her
life, Carrie, who was in the 7th grade, began to
cut herself. This behavior continued on and off
for the next 20 years. Her parents suspected
nothing and they had no evidence to suggest
their daughter was struggling emotionally.
There was no hint of her underlying pain, in part
because Carrie continued to excel in school.
Immediately after her high school graduation
Carrie moved to North Carolina where she
experienced her first manic and hypomanic
episodes, which included risky and potentially
dangerous behavior, a marriage and divorce in
under five months when she was 19. Her parents
didn’t learn about her diminishing mental
health until thoughts of suicide and “obsessive
thoughts of people dying” drove her to check
into an emergency room. Her symptoms
precipitated an involuntary admission to the
state psychiatric hospital.
She hit a low point five years ago when she
checked herself into a hospital because of
A Researcher’s Perspective
In the language of social media practitioners,
the drug ketamine seems to be trending now in
research institutes around the country. It’s being
studied as a potential treatment for various
psychiatric disorders, including depression and
two years ago we reported on the progress of a
number of NYSPI researchers seeking to learn
more about its potential. Dr. Joshua Kantrowitz
is now leading a pilot study investigating
whether or not ketamine is effective in treating
depression in people diagnosed with bipolar
disorder, a type of depression that is notoriously
difficult to treat. Once patients are screened and
their diagnosis confirmed, they are treated with
FDA-approved treatment for three weeks. “After
that we re-rate them. If their depression hasn’t
gotten better – if there’s no substantial change
11
– we give them a dose of ketamine,” said Dr.
Kantrowitz. Patients are given a small dose of
the drug, followed by D-cycloserine (DCS), an
oral antibiotic with demonstrated antidepressant
effects. Dr. Kantrowitz is interested in whether
DCS will sustain the improvement in symptoms
from ketamine.
Patients also get an MRI during the ketamine
infusion so researchers are able to see changes
in glutamate levels. Unlike many medications
on the market, ketamine works through the
glutamate neurotransmitter system in the brain.
By causing a surge in glutamate levels, ketamine
makes people with depression feel better. The
improvement is rapid – in prior studies most
patients reported feeling better after a few hours
suicidal thoughts. What she thought would
be a week-long recovery period turned into a
five-year leave of absence from her successful
professional career. In April of this year -- nearly
20 years since her first depression, a trail of
failed treatments behind her, a loss of $20,000 in
medical expenses and unrelenting depression Carrie found an article on ketamine, which led her
to a listing of Dr. Joshua Kantrowitz’s research
study on clinicaltrials.gov. His was the only study
on ketamine that provided an FDA-approved
treatment during the study. Carrie’s decision to
enroll in a research study was a last ditch effort
to get better. While not yet completely well, she’s
glad she gave research a try: “I went into the
trial with little hope because I did not want to be
disappointed if it didn’t help, especially knowing
that all my previous treatment attempts had
failed. Needless to say, I was happily surprised
to show any improvement.” She added, “I have
made the biggest leap thus far which is the
reemergence of hope. Something has proved
capable of improving my many years long battle
with debilitating bipolar depression.”
- but transient, lasting only about 7-10 days.
“Within four hours, people who are going to
improve generally show some improvement,”
said Dr. Kantrowitz of findings in the study so
far. He added, “The improvement tends to peak
one to three days afterwards...People tend to
show at least a 20% improvement from their
pre-ketamine depression level. Unfortunately,
the effects don’t last more than a week, and
my hope is that DCS will prolong the period of
improvement.”
Following this pilot study, Dr. Kantrowitz hopes
to do a large-scale trial to demonstrate ketamine
and DCS’ combined effectiveness in large
groups of people.
To learn more about this study, call 646-7748726 or -6738.
www.columbiapsychiatry.org
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HIV/AIDS and Psychiatry
Editors: John Joska, Dan Stein, Igor Grant
Publisher: Wiley-Blackwell
April 2014
HIV Center Investigators Contribute to Book from the World Psychiatric Association
HIV Center investigators Drs. Robert Remien, Francine Cournos, Milton Wainberg, Karen McKinnon, and Reuben Robbins are
contributors to the important new resource book “HIV/AIDS and Psychiatry” published in conjunction with the World Psychiatric
Association. The investigators co-authored chapters on “Epidemiology of Psychopathology in HIV,” “Intervention in HIV and
Psychiatry: Behavioral and Psychotherapeutic Approaches,” and “Special Populations and Public Health Aspects.”
This book provides clinicians with a comprehensive evidenced-based and practical approach to the management of patients with HIV infection and comorbid mental disorders. It provides up-to-date and clear overviews of current clinical issues, as well as the relevant basic science. Information and data
from studies of different HIV groups (eg men who have sex with men) make the text relevant to a broad spectrum of clinicians, including those working
with low socioeconomic status groups in high income countries and those working in the developing world.
The book uses the popular format of the World Psychiatric Association’s Evidence and Experience series. Review chapters summarize the evidence on the
epidemiology, pathogenesis and clinical aspects of mental disorders in HIV, and interventions (both psychotherapy and psychopharmacology including
drug-drug interactions). These are complemented by commentaries addressing particular facets of each topic and providing insight gained from clinical
experience.
Psychiatrists, psychologists and all mental health staff working with HIV-infected patients will find this book of great benefit. For more information, visit:
http://www.wiley.com/WileyCDA/WileyTitle/productCd-1118339541.html
Psychiatry, Third Edition
Editor: Janis Cutler, MD
Publisher: Oxford University Press
June 2014
Fully updated for DSM-5 and designed specifically for medical students, as well as other trainees in the health professions,
Psychiatry Third Edition is a dynamic introductory textbook in psychiatry. Ideally suited for first and second year medical students
during their psychopathology course and third year medical students during their psychiatry clerkship, the material is presented
in a clear, concise, and practical manner perfect for exam preparation. The authors provide a thorough yet concise introduction to
clinical psychiatry, focusing on basic clinical skills like recognition and assessment of psychiatric illness. Clinically relevant information is emphasized,
including practical interviewing techniques.
Psychiatry Third Edition also uses case studies, DSM-5 guidelines, and extensive tables offset from the text to act as a comprehensive yet concise guide for
the busy medical student studying for exams. In response to DSM-5, the third edition has been reorganized and fully updated to include the new disorders
and classification of psychiatric illness.
“A Vision for LGBT Health” Event Highlights LGBT Health Initiative
have received with regard to LGBT health. In
1987, we had to convince people about the
significance of the AIDS epidemic. Today, our
colleagues understand the need to address
LGBT health and have invited us to join them
as partners in their work.”
Several of these partners were members of
the panel discussion that followed, sharing
perspectives from their own disciplinary and
institutional perspectives. Columbia University
School of Nursing Dean Dr. Bobbie Berkowitz
provided insights from her experience on an
Institute of Medicine panel on LGBT health, on
12
which Dr. Bockting also served. Dr. Jonathan
Amiel, Associate Dean for Curricular Affairs at
P&S, surveyed educational and clinical efforts
at CUMC, noting both recent progress and
considerable persisting needs. Dr. Jack Pula,
a Columbia-affiliated psychiatrist, spoke of the
unique health challenges facing transgender
people, himself included. Offering an outside
perspective, Dr. Ken Mayer presented a stateof-the-art overview of the LGBT Health field
from his vantage as Director of the Harvardaffiliated Fenway Health, a provider to the
LGBT community in Boston.
(continued from page 10)
Panelists (left to right) Dr. Jonathan Amiel,
Dr. Jack Pula, Dr. Bobbie Berkowitz
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